dental venue - Root Canal Therapy

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Root Canal Therapy

Teeth are held in the jaw by their roots. Front teeth normally have one root but teeth further back will have two, three or even four.

Inside the root, there are nerves and a blood supply. When the tooth is healthy, the nerves are alive. Decay or trauma, however, may cause them to die. Left untreated, an abscess may form at the tip of the root. Not too long ago, if a tooth was infected or the nerve in the tooth was dying, the tooth would have to be pulled. Root canal therapy allows you to keep teeth with infected or dying nerves.

The root canal is the space within the root of the tooth which contains blood vessels and nerves. These tissues travel from the apex of the tooth (the tip of the root) to an enlarged cavity within its body (pulp chamber). This tissue is known as the pulp; it supplies nourishment and sensation to the tooth. It's interesting to note that the only "type" of sensation the pulp can perceive is pain. Hot, cold, or any stimulation - is perceived as pain.

The pulp also has a formative function. It gives the tooth the ability to continue to generate dentin. In many cases where the tooth is attacked by a slowly advancing cavity, the pulp will lay down additional dentin in the chamber in an attempt to wall itself off from the advancing decay.

More than 95 percent of root canal treatments are successful.

What is Endodontic (root canal) treatment?

"Endo" means internal or inside and "odont" means tooth. Endodontic treatment (aka Root Canal treatment) refers to dental treatment involving the nerve space or root canal of the tooth. The procedure involves removing the infected nerve, cleaning out the damaged pulp and filling the canal with a material called gutta percha. It effectively saves the tooth and alleviates the associated pain.

The purpose of root canal therapy is not only the elimination of pain and swelling, it also aims at getting rid of bacteria causing the infection and preventing the infection from recurring. It accomplishes this by cleaning the necrotic pulp from the canal and sealing the root against bacteria.

Teeth treated with root canal therapy tend to become brittle over time. This period of time varies from person to person. Thus, any endodontically treated tooth should be restored as soon as possible; your dentist may have recommend placement of a post and crown as a final restoration.

Root canal therapy can usually be performed in one visit; patients are usually surprised to find that in most cases it is completely painless.

Why does the pulp become damaged?

One of the most common reasons for root canal treatment is an infected or abscessed tooth, which may result from a deep cavity, periodontal disease, or a fracture. Occasionally, trauma, such as a sudden blow to the mouth, can result in damage to the pulp of a tooth.

Why do I need endodontic treatment?

When the pulp in the tooth "dies", the pulp chamber or root canal becomes necrotic. Bacteria have a field-day! They multiply and begin to leak out of the root's apex. In response to the bacterial presence in bone, an abscess will form around the apex. An infection in the root canal of a tooth can cause:

Swelling that may spread to other areas of the face or neck or head
Swelling with pus in the area around the tooth root
Bone loss around the tip of the root
A drain hole (called a sinus tract) between the root of the infected tooth and the skin. The sinus tract can occur thorough the side of the tooth into the gums or through the cheek to drain on the skin.

What will happen if I leave the tooth untreated?

If the inflamed pulp is not treated, it will become necrotic and die. Eventually, the bone surrounding the root may be destroyed, resulting in increased mobility and possible extraction.

Common Causes of Pulpal Death

Decay occurring close to the pulp. Unfortunately, the anatomy of some teeth is such that their

pulps are very close to the surface of the tooth. These teeth are more susceptible to pulpal

trauma; a relatively shallow cavity may cause the pulp to die.

Trauma. Moderate trauma may cause injury to the pulp that the body is able to repair. Often,

though, the body is unable to repair the damage and the pulp dies.

Large fillings. Large fillings which are close to the pulp chamber are a constant source of

irritation to the pulp. Over time this constant source of irritation may cause the pulp to become

necrotic.

Non-painful pulpal death! Often people have pulpal damage without even knowing it. For many

there are no symptoms - it doesn't hurt! Your dentist may discover a "dead" tooth in an x-ray.

Necrotic teeth often have abscesses which result in bone destruction and increased tooth mobility.

It's important to have these teeth endodontically treated even though they don't hurt; studies have

shown long term dental infections to be linked to heart disease and strokes.

Signs & Symptoms

Sensitivity to cold and hot temperatures. Severe pain which lasts for some time after the hot or

cold has been removed is a sign that the pulp may have irreversible damage. Sensitivity to hot and

cold may also be due to dental decay, gum recession or a crack in the tooth. Prolonged sensitivity

to hot and cold is usually one of the early symptoms of pulp damage.

Pain on chewing or pressure. This may also indicate a crack in a tooth, or periodontal disease

or a endodontic abscess.

The tooth is dead, so why does it still hurt?

When a tooth "dies", the cause of pain is the pressure of the 'dead' contents on the inside of the

tooth (ie. bacteria, necrotic pulpal tissue and debris), on the surrounding bone and gums

(periodontal ligament). The tooth may be extremely sensitive to even the slightest touch.

Procedure

An x-ray will show the shape of the root canals and whether there are any signs of infection

in the surrounding bone. Some tooth roots are easier to fill than others because of their

shape. Sometimes the x-ray will show that a root filling will not be successful. Your dentist will

discuss this with you.

Your dentist will numb the area near the tooth first so that the root filling is painless.

To keep root canals dry during treatment, your dentist will stretch a sheet of thin rubber around

the tooth on a metal or plastic frame outside the mouth.

Your dentist will make a hole in the tooth and enlarge it until they can see the opening of the root canal.

Narrow files will be used to locate the root canals and remove necrotic debris.

Your dentist may need to take additional x-rays to measure the length of the root canals.

Finally, your dentist will fill the roots with rubbery materials and with pastes that set hard.

Following Treatment

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an

over-the-counter analgesic. From this point on, brush and floss regularly, avoid chewing hard

foods on the treated tooth, and see your dentist regularly.

Benefits Of Root Canal Therapy

Nerve damage can cause severe toothaches. The pain will usually end very quickly when the

root canal is cleaned out.

Without a root filling, a tooth with a dead nerve will probably have to be taken out.

Root fillings are usually successful and can last many years.

Sometimes there can be an infection (the tooth will ache and become painful to bite on) but

re-treatment can be successful

Risks

If root canal therapy is suggested by your dentist, it’s important to have the tooth treated as

soon as possible. An infection that is allowed to continue, will likely result in the formation of an

abscess in the bone surrounding the root. This will lead to destruction of the underlying bone

and may make it impossible to save the tooth; in addition, the infection can spread to adjacent

teeth and could result in fever and facial swelling.

If you have symptoms, such as swelling, sensitivity to hot and cold, discomfort from air stimulation or pressure (ie. it hurts to touch your tooth), contact your dentist immediately. If you have recently undergone root canal therapy and you are experiencing recurring discomfort, notify your dentist as soon as possible.

Note: It is important to note that before beginning any course of treatment you should see your dentist. Please note that without the benefit of a full dental examination, including a review of medical history, dental x-rays, and diagnostic aids, no attempt can be made to provide specific diagnosis or recommended courses of treatment. However, we will be happy to update our site to include topics you feel deserve mention. contact us